PROJECT_SUMMARY_ABSTRACT_nView_medical Surgicalinaccuraciesimpactpatientsafetyandincreasehealthcarecosts.Spinalfusionsareaprimeexample: with500,000proceduresperyearintheUSitisthesixthmostfrequentprocedureandreoperationratesare 13%. There are an estimated 22,000 revision surgeries due to misplaced screws that could be avoided if intraoperative3Dguidancewasstandard.Thetotalcostoftherevisionsurgeriesduetomisplacedscrewsin the US exceeds $600M per year and could largely be reduced. nView medical is developing the next generation image guidance technology that will lead to more accurate, lower cost, and safer ImageGuided Interventions (IGI). nView?s innovation provides 3D images in realtime, navigation capability, and lowdose operation. nView will focus first on spine surgery as strong benefits from 3D image guidance have already beenestablished,buttheproposedplatformtechnologyappliesbroadlytomostinterventionalradiologyand surgical applications, such as oncology and vascular minimally invasive interventions, as well as spine, orthopaedicsandcardiovascularsurgeries. In Phase I, this research will provide objective physics image quality metrics for its scanner to establish a baseline versus alternative technologies. This research will then prove the clinical value of the proposed guidance system, first by demonstrating that the realtime 3D updates lead to accurate visualization and trackingofsurgicalinstrumentationmakingthescannervaluableintraoperativelyandsecond,toprovethe clinicalvalueinsimulatedsurgeries,showingthataccuracycanbeimprovedandsurgicaltimereducedversus state of the art alternatives. Positive preliminary results based on user observer tests support that nView?s imageguidancesystemleadstohigheraccuracyatlowerdosethanalternativesolutions.PhaseIIwillexpand theclinicalapplicabilityoftheinnovationandconfirmthebenefitsofincreasedaccuracy,decreasedsurgical time and reduced xray exposure in actual Image Guided Interventions. The nView team members, with backgroundfrombothindustry(GEHealthcare,Carestream)andacademia(UniversityOfUtah,UCDavis), havedeepexperienceinmedicalimaging,xrayimagereconstructionandsurgicalnavigation.